The thyroid is a small butterfly-shaped gland located at the base of the neck, between the collarbone and voicebox. It regulates many body functions, including growth, development, and metabolism.
A sore throat, pain, or tenderness around the throat area can be a sign of thyroid problems such as thyroiditis.
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Thyroiditis is swelling and inflammation of the thyroid gland. Depending on the cause, it can be painful, tender, or painless.¹
Thyroiditis can lead to an overactive thyroid (hyperthyroidism), with increased levels of thyroid hormone in the blood. Alternatively, it can cause an underactive thyroid (hypothyroidism), resulting in low levels of thyroid hormone in the blood.
Doctors classify the types of thyroiditis based on the symptom onset, causes, and recognizable symptoms.
Common types of thyroiditis include:
Viral thyroiditis is also known as subacute thyroiditis, De Quervain’s thyroiditis, giant cell thyroiditis, and subacute nonsuppurative thyroiditis.
Viral thyroiditis is the most common cause of thyroid pain. Researchers believe a viral infection causes an immune reaction.²
Several medications can cause thyroiditis. These include:
Amiodarone, which treats heart problems
Interferons, which treat chronic viral infections and cancer
Lithium, which treats bipolar disorder and major depressive disorder
Cytokines, which treat chronic viral infections and cancer
Not everyone who takes these medications will develop drug-induced thyroiditis, but it is a potential complication to be aware of.
The symptoms of drug-induced thyroiditis, such as pain around the thyroid, are temporary and usually resolve after you stop taking the medication. Always talk to your doctor before stopping or changing the dose of any medicine you take.
Autoimmune disease is a common cause of thyroiditis and is often painless. Without treatment, autoimmune thyroiditis can become chronic and lead to permanent thyroid damage.
The two main types of autoimmune thyroiditis are:
Hashimoto’s thyroiditis is a condition where your immune system attacks the thyroid gland, making it unable to produce enough thyroid hormones. This leads to hypothyroidism.
Occasionally, women who have given birth can develop postpartum thyroiditis 6–12 months after delivery. This condition causes a temporary increase in the production of thyroid hormones.
Postpartum thyroiditis may be an autoimmune reaction caused by antithyroid antibodies attacking the thyroid. Fortunately, postpartum thyroiditis is temporary, and thyroid function usually returns to normal within 12 months.
Postpartum thyroiditis is less common than other thyroiditis and only occurs in 5-7% of postpartum women.²
Viral thyroiditis has a sudden onset of symptoms, and it causes a swollen and inflamed thyroid gland. Pain is the most common symptom of viral thyroiditis, and it can worsen after turning the head, coughing, and swallowing.³
Other common symptoms of viral thyroiditis are:
A high temperature
A general sense of being unwell
Fatigue and weakness
Pain in the neck, potentially spreading to the ears, jaw, throat, and upper chest
A sore throat is typically one of the initial symptoms of viral thyroiditis
A tender goiter (thyroid enlargement) when you apply pressure to the thyroid gland
Difficulty swallowing and hoarseness in the throat
Other symptoms of an upper respiratory tract infection
Thyroiditis often occurs in two stages:
In the first stage, your thyroid gland becomes overactive and produces too many thyroid hormones (hyperthyroid stage). This is called thyrotoxicosis.
During this stage, some symptoms you may experience include:
Increased bowel movements
Irregular menstrual cycle
Weight loss, despite having an increased appetite
In the second stage, inflammation can cause your thyroid to become underactive and not produce enough thyroid hormone.
During this stage, you may experience symptoms similar to hypothyroidism. These can include:
Irregular menstrual cycle
Viral thyroiditis can affect anyone. However, it is more common in:
Women aged 20-50
People who have had a viral upper respiratory infection of the ear, nose, sinus, or throat in the past two to eight weeks, including viral illnesses such as:
The common cold
The summer and autumn months (June to September in the Northern Hemisphere)⁵
Diagnosing thyroiditis involves several tests. This can help your doctor determine the exact cause of thyroiditis and rule out other causes of thyroid problems.
Due to the throat pain people commonly experience, doctors often mistake thyroiditis for a throat infection. A misdiagnosis can prevent proper treatment, and it’s another reason why these tests are important.
In some cases, neck pain and a tender thyroid gland may be enough to diagnose subacute thyroiditis, and other methods can confirm the condition. These methods may include:
The blood tests to diagnose thyroiditis and rule out other causes include:
Thyroid hormones: Thyroxine (T4) and triiodothyronine (T3)
Thyroid-stimulating hormone (TSH)
Thyroid antibodies (thyroid stimulating and thyroid peroxidase antibodies)
C-reactive protein (CRP)
Erythrocytes sedimentation test (EST)
In viral thyroiditis, EST and CRP are usually high. T3 and T4 levels will be high, and TSH levels will be low during the initial hyperthyroid stage. Thyroid antibodies usually aren’t detectable.⁶
A thyroid ultrasound can show whether there is swelling and inflammation of your thyroid and if there are any nodules.
A thyroid ultrasound can suggest whether there could be other causes of thyroid problems. In viral thyroiditis, the thyroid will be normal or enlarged on an ultrasound; if enlarged, it will be diffused, meaning the enlargement is spread across the entire gland.
In a physical exam, your doctor will examine your head, eyes, nose, throat, and thyroid gland.
Iodine is an important mineral your thyroid needs to produce hormones. A radioactive iodine uptake test involves ingesting radioactive iodine through mouth or injection. The examiners can detect how much iodine is taken up by your thyroid gland.
People with viral thyroiditis typically have a low radioactive iodine uptake.
Some ways that your doctor can treat and manage viral thyroiditis include:
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, can manage pain. These are available over the counter.
A doctor can prescribe steroids such as prednisone. They may recommend steroids if NSAIDs aren’t helping with pain management after two to three days and you continue to have symptoms such as severe neck pain. Steroids can reduce swelling and inflammation.⁷
Occasionally, thyroiditis can permanently damage the thyroid and cause long-term hypothyroidism. Some people also experience recurrent viral thyroiditis. Thyroid hormone replacement drugs, such as levothyroxine, may help in these instances. A doctor needs to prescribe these medications.
Many people who experience viral thyroiditis will not need thyroid hormone replacement.
You may experience a fast heart rate, agitation, and tremors during the hyperthyroid stage of viral thyroiditis.
Beta-blockers may reduce these symptoms. Your doctor may prescribe them to you if appropriate.
It’s advisable to rest while recovering from viral thyroiditis.
The majority of people with viral thyroiditis can recover at home. However, if you experience moderate to severe viral thyroiditis, you may need to be cared for in a hospital setting.
It’s important for medical professionals to monitor your thyroid function through blood tests every two to eight weeks to determine the disorder's progress.
The symptoms of viral thyroiditis usually last for one to three months. In a small number of people, it can take 12–18 months to recover from viral thyroiditis. After this, thyroid function typically returns to normal, and most people fully recover from thyroiditis.
However, even after recovering, around 5% of people are left with permanent hypothyroidism and need to take thyroid medications to ensure they have adequate thyroid hormone levels. Thyroiditis recurs in around 2% of people.³
Thyroiditis is an inflammation of the thyroid gland, which can lead to hyperthyroidism and hypothyroidism. There are numerous causes and types of thyroiditis, which all have different outlooks. Subacute thyroiditis, for instance, is caused by a viral infection and can cause a sore throat, among other symptoms.
If you think you may have thyroiditis or any other thyroid disorder, see your doctor as soon as possible. They will be able to diagnose you and start the best form of treatment.
Thyroiditis can cause pain in the throat. Other thyroid problems, such as cancer, can also include throat pain as a symptom. You may feel like you have a lump in your throat when you swallow.
The front of your throat may be sore to the touch in subacute thyroiditis.
A sore throat is a possible symptom of thyroid cancer. However, many thyroid disorders aside from cancer can also cause a sore throat.
Thyroid nodules can cause a persistent cough and a sore throat. Acute thyroiditis and subacute thyroiditis are also common thyroid-related causes of sore throat.
De quervain thyroiditis (2022)
Subacute thyroiditis (2000)
Subacute thyroiditis | Penn Medicine